We arrived in Bangkok last night and had a quick flight to Chiang Mai Kao today. It’s hot and tropical and beautiful. Off in a van now. Hopefully no one gets carsick.
In this country, I find I don’t think about infant mortality or under 5 mortality. It’s not that infants or children never die in the US… but when it happens, we think of it as an isolated tragedy. Something that might and ought to have been prevented. With a national infant mortality (IMR: that is, death of a child under 12 months) rate of 5.98/1000, we are in the lowest quartile.
Burma’s IMR is 47.74/1000. 48 out of every thousand infants don’t survive the first year. (Source: CIA: The World Factbook.)
The World Health Organization estimates that 33/1000 infants in Myanmar don’t survive the first 28 days, and 40% of that mortality is in the first 24 hours of life. Babies just have a hard time transitioning to life in the “real world.”
Mae La Refugee Camp (home to 45,000 IDPs) has a maternity hospital, staffed entirely by Karen (one of the ethnic groups that have fled). They have been able to reduce their IMR significantly. I hope that introducing HBB among more of the Karen medics and their FBR partners, will be another step toward helping babies survive.
Thailand, just east of Myanmar, has been a primary refuge for those fleeing the violence in Myanmar. According to the UNHCR, 90,000 Burmese refugees currently live in Thailand. Nine closed camps opened in the 1980’s, and some of the refugees have been confined there for more than twenty years. The Thailand Burmese Border Consortium reports that an estimated 450,000 Burmese nationals are currently displaced along the east and south border. The refugees (IDPs, or Internally Displaced People) live in terrible poverty and often have little or no access to medical care.
Free Burma Rangers is a non-governmental organization (NGO) that works to document the refugee situation and alleviate the sufferings of Burmese IDPs. Sonia and I will be teaching HBB (Helping Babies Breathe) to a group of Burmese medics being trained by Free Burma Rangers. The Huffington Post had a great article (with great photos) recently on the Jungle School of Medicine. The mission of the school is to train indigenous health workers to provide world-class health care to themselves. I am so honored to be a part of their work.
Four days till I’m on a plane to Thailand.
My journey began fifteen months ago, during my second trip to Haiti to work in a cholera clinic. One of the women who had come in during the night was having a lot of pain. When I examined her in the morning, I thought she didn’t look like a typical cholera patient. Actually, she didn’t have cholera; she was in labor.
Our clinic staff mobilized quickly, preparing a semi-private area (that had just been bleached) in which she could have her baby. It happened to be a day we were short on gloves, so I washed the pair I had in as much soapy water as I could. We disinfected scissors and found clean blankets. The neonatologist began winding IV tubing into the adult sized ventilation mask to try to make it smaller in case the baby wasn’t breathing and we had to rescuscitate the her.
Our clinic had a very specific mission and very specific rules about what the volunteers could do, and letting me travel in the back of a tap-tap in case the baby came on the way to the maternity hospital was not of them. My supervisor heard my fears that the baby might die in the back of the truck but couldn’t allow me to deliver the baby in the clinic. She asked me what to do. I said Pray.
This is a tap-tap. Well, actually it’s a cola truck. But if you took out the cola and filled it with people going to work, it would be a tap-tap. If you put a woman in labor in it, it would be an ambulance.
While Maggie was praying, I caught a beautiful, little baby and laid her, crying, on her mother’s belly. God is good.
The next week, when I was home, it was time to renew my NRP certification. The NRP is the Neonatal Resuscitation Program, and every licensed birth attendant in this country maintains certification in this program. I told my story to the person retesting me and said I had a desire to adapt it for the developing world. She said the AAP had already done it.
It’s official. I have travel dates and a really expensive plane ticket to go to Thailand in September, where my colleague Sonia and I will be teaching Helping Babies Breathe (HBB) to a group of midwives and medics who work with displaced Burmese refugees. The goal of the program worldwide is to give birth attendants in under-resourced places the skills to resuscitate a baby without the need for electricity or oxygen.
This month has been full of planning: teaching Sonia the curriculum, researching tickets (expensive), visas (not necessary), hotels (affordable), and prayer (priceless). If you would join me in the prayer part, I’d be grateful! And if you know of a printing company in Thailand (no FedEx/Kinkos there!) let me know.